US20090254093A1 - Patient-Specific Alignment Guide - Google Patents
Patient-Specific Alignment Guide Download PDFInfo
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- US20090254093A1 US20090254093A1 US12/486,992 US48699209A US2009254093A1 US 20090254093 A1 US20090254093 A1 US 20090254093A1 US 48699209 A US48699209 A US 48699209A US 2009254093 A1 US2009254093 A1 US 2009254093A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
- A61B17/175—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for preparing the femur for hip prosthesis insertion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00526—Methods of manufacturing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/568—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor produced with shape and dimensions specific for an individual patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Dentistry (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
Description
- This application is a continuation-in part of U.S. application Ser. No. 12/039,839, filed on Feb. 29, 2008, which claims the benefit of
provisional application 60/892,349, filed Mar. 1, 2007, and which is a continuation-in part of U.S. application Ser. No. 11/756,057, filed on May 31, 2007, which claims the benefit of U.S. Provisional Application No. 60/812,694, filed on Jun. 9, 2006. - This application is also a continuation-in-part of U.S. application Ser. No. 12/025,414, filed on Feb. 4, 2008, which claims the benefit of U.S. Provisional Application No. 60/953,637, filed on Aug. 2, 2007.
- The disclosures of the above applications are incorporated herein by reference.
- Various custom made, patient-specific orthopedic implants and associated templates and alignment guides are known in the art. Such implants and guides can be developed using commercially available software. Custom implant guides are used to accurately place pins, guide bone cuts, and insert implants during orthopedic procedures. The guides can be made from a pre-operative plan formed from MRI or CT scans of the patient and rely on matching a subcutaneous anatomic feature for correct positioning.
- The present teachings provide a patient-specific alignment guide for a femoral resurfacing or replacement procedure.
- The present teachings provide an orthopedic apparatus including an alignment guide attachable to a femoral joint surface of a femur of a patient. The alignment guide has a patient-specific three-dimensional engagement surface, and at least one guiding portion defining a guiding passage. The engagement surface anatomically matches a corresponding portion of the femoral joint surface.
- The present teachings provide an orthopedic apparatus including a frame including a body and a longitudinal post extending from the body, a securing member threadably couplable to the post; and a plurality of arms coupled to the body and movable between an open configuration and a closed configuration. The plurality of arms can be engaged to a femoral joint surface of a patient in the closed configuration. Each arm has a clamping portion with a patient-specific three-dimensional engagement surface. The engagement surface anatomically matches a corresponding portion of the femoral joint surface.
- In various embodiments, the present teachings provide an orthopedic apparatus including a reusable frame having a body and a plurality of arms coupled the body. The plurality of arms can be engaged to a femoral joint surface of a patient. The apparatus also includes a plurality of disposable clamping portions. Each clamping portion can be removably coupled to a corresponding arm, and each clamping portion can include a patient-specific three-dimensional engagement surface. The engagement surface anatomically matches a corresponding portion of the femoral joint surface of the patient.
- Further areas of applicability of the present invention will become apparent from the description provided hereinafter. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the invention.
- The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein:
-
FIG. 1 is a flowchart of an exemplary method of preparing patient specific alignment guides according to the present teachings; -
FIG. 2 is an environmental view of a patient-specific guide according to the present teachings; -
FIG. 3 is an environmental view of a patient-specific guide according to the present teachings; -
FIG. 3A is a sectional view ofFIG. 3 taken alongaxis 3A; -
FIG. 4 is an environmental view of a patient-specific guide according to the present teachings; -
FIG. 4A is a sectional view ofFIG. 4 taken alongaxis 4A; -
FIG. 5 is an environmental view of a patient-specific guide according to the present teachings; -
FIG. 5A is a sectional view ofFIG. 5 taken alongaxis 5A; -
FIG. 6 is an environmental view of a patient-specific guide according to the present teachings; -
FIG. 6A is an exploded view of an exemplary connection for patient-specific guide ofFIG. 6 ; -
FIG. 6B is an exploded view of an exemplary connection for patient-specific guide ofFIG. 6 ; -
FIG. 7 is an environmental view of a patient-specific guide according to the present teachings; -
FIG. 7A is a sectional view ofFIG. 7 taken alongaxis 7A; -
FIG. 7B is an exploded view of an exemplary modular component of the patient-specific guide ofFIG. 7 ; -
FIG. 7C is an exploded view of an exemplary modular component of the patient-specific guide ofFIG. 7 ; -
FIG. 7D is an exploded view of an exemplary component of the patient-specific guide ofFIG. 7 ; -
FIG. 8 is a perspective view of a patient-specific guide according to the present teachings; -
FIG. 8A is a plan view of patient-specific guide ofFIG. 8 ; -
FIG. 8B is an environmental sectional view of a patient-specific component of a guide according to the present teachings; -
FIG. 8C is an environmental sectional view of a patient-specific component of a guide according to the present teachings, the sectional view taken along a plane perpendicular to the axis of a femoral neck of a patient; -
FIG. 8D is an environmental perspective view of a patient-specific guide according to the present teachings; -
FIG. 8E is a sectional view ofFIG. 8D taken alongaxis 8E; and -
FIG. 9 is a perspective environmental view of a patient-specific guide according to the present teachings. - The following description is merely exemplary in nature and is in no way intended to limit the scope of the present teachings, applications, or uses. For example, although the present teachings are illustrated for alignment guides in knee surgery, the present teachings can be used for other guides, templates, jigs, drills, rasps or other instruments used in various orthopedic procedures.
- The present teachings provide a method for preparing patient-specific alignment guides for use in orthopedic surgery for a joint, such as, for example, the knee joint. Conventional, not patient-specific, prosthesis components available in different sizes can be used with the alignment guides, although patient-specific femoral and tibial prosthesis components prepared with computer-assisted image methods can also be used. Computer modeling for obtaining three dimensional images of the relevant patient's anatomy, patient-specific prosthesis components, and the alignment guides and templates can be provided by various CAD programs and/or software available from various vendors or developers, such as, for example, from Materialise USA, Ann Arbor, Mich.
- Referring to
FIG. 1 , in preoperative planning, imaging data can be obtained of an entire leg including a joint to be reconstructed at a medical facility or doctor's office, ataspect 10. The imaging data can include a detailed scan of a hip, knee and ankle. The imaging data can be obtained using MRI, CT, X-Ray, ultrasound or any other imaging system. In some cases, the scan may be performed with the patient wearing an unloader brace to stress the ligaments. The scan data obtained can be sent to a manufacturer, ataspect 20. The scan data can be used by the manufacturer to construct a three-dimensional image of the joint and prepare an initial implant fitting and alignment protocol detailing the fit of the implant. The fitting and alignment protocol can be stored in any computer storage medium, in a computer file form or any other computer or digital representation. The initial implant fitting and alignment protocol can be obtained using standard alignment methods or using alignment methods provided by or based on the preferences of individual surgeons. - As discussed above, in the preoperative planning stage of a surgical procedure, multiple image scans of portions of the patient's anatomy related to the procedure are obtained. Image markers visible in the scan can be placed on the patient's anatomy to allow image scaling and orientation. The obtained scans of the desired anatomy can be correlated to one another to reconstruct an image of the patient's specific anatomy in three-dimensions.
- The outcome of the initial fitting is an initial surgical plan that can be printed or represented in electronic form with corresponding viewing software. The initial surgical plan can be surgeon-specific, when using surgeon-specific alignment protocols. The initial surgical plan, in a computer file form associated with interactive software, can be sent to the surgeon, or other medical practitioner, for review, at 30. Using the interactive software, the surgeon can manipulate the position of images of various implant components relative to an image of the joint. The surgeon can modify the plan and send it to the manufacturer with recommendations or changes. The interactive review process can be repeated until a final, approved plan is sent to the manufacturer, at 40.
- Various methods of sending the initial and final surgeon-approved surgical plans can be used. The surgical plans can be, for example, transferred to an electronic storage medium, such as CD, DVD, flash memory, which can then be mailed using regular posting methods. In various embodiments, the surgical plan can be e-mailed in electronic form or transmitted through the internet or other web-based service.
- After the surgical plan is approved by the surgeon, patient-specific alignment guides for the femur and tibia can be developed using a CAD program or other three-dimensional modeling software, such as the software provided by Materialise, for example, according to the surgical plan, at 50. Computer instructions of tool paths for machining the patient-specific alignment guides can be generated and stored in a tool path data file, at 60. The tool path can be provided as input to a CNC mill or other automated machining system, and the alignment guides can be machined from polymer, ceramic, metal or other suitable material, and sterilized, at 70. The sterilized alignment guides can be shipped to the surgeon or medical facility, at 75 for use during the surgical procedure. Patient-specific components or portions are defined as those constructed by a surgical plan approved by the doctor using three-dimensional images of the specific patient's anatomy and made to closely conform and mate substantially as a negative mold of corresponding portions of the patient's anatomy, including bone surfaces with or without associated soft tissue, such as articular cartilage, for example.
- Images of the knee joint anatomy can include images of the joint surfaces of the distal femur and proximal tibial with or without the associated soft tissues, such as articular cartilage, on the respective bone surfaces. The alignment procedure can make use of the mechanical, anatomic, transepicondylar and cylindrical axes in various degrees. Multiple alignment procedures can be provided to accommodate the experience and preference of individual surgeons. For example, the alignment procedure can be based on the anatomic and mechanical axes, or can be substantially based on the cylindrical axis. Further, the alignment procedure can be deformity-specific, such that the procedure is adapted, for example, to a valgus or varus deformity.
- Similarly, images of the hip joint anatomy of the joint surface of the proximal femur with or without the associated soft tissues, such as articular cartilage, on the respective bone surfaces can be used in the alignment procedure. The alignment procedure can include, for example, the selection of an anteversion angle, a femoral neck angle and other orientations for positioning a femoral implant, such as a resurfacing component, without notching or impinging on the femoral neck.
- Referring to
FIG. 2 , an exemplary multiple-componentfemoral alignment guide 100 that can be manufactured using the method ofFIG. 1 is illustrated. In this exemplary embodiment, thealignment guide 100 is shown with first and secondadjacent components alignment guide 100. The first andsecond components coupling mechanism 120 can be selected from a variety of mechanisms that provide easy intra-operative assembly. In various embodiments, for example, thecoupling mechanism 120 can be a snap-on connection between the two components. In various embodiments, thecoupling mechanism 120 can be an interlocking mechanism, such as a keyway-and-key mechanism, a dovetail mechanism, a puzzle-like interlocking mechanism, or any other interlocking mechanism. In various embodiments, thecoupling mechanism 120 can include a permanent or temporary hinge or other pivotable structure that allows relative motion between the adjacent components, such that one component can be rotated relative to the other component for ease of positioning on the patient. The components can be permanently pivotably coupled with the hinge or can be detachable. - The
exemplary alignment guide 100 can be configured as patient-specific for thefemoral neck 86 of a proximal femur, as illustrated in FIG. 2. Thealignment guide 100, when assembled, can wrap around and mate in three dimensions with thefemoral neck 84 for assisting in the placement of an alignment pin for femoral head resurfacing. Thefirst component 102 can include a guiding portion orformation 108 and aportion 112 having a first three-dimensional innerbone engagement surface 113 that can anatomically match or mate with a portion of thefemoral neck 86 in three dimensions. The guidingformation 108 can be in the form of a sleeve including aguiding passage 109, a bore, a hole, or other opening through which an alignment pin or drill bit or other stool or fastener can be inserted. Thesecond component 104 can be coupled to thefirst component 102 by thecoupling mechanism 120. Thesecond component 104 can include a second three-dimensional innerbone engagement surface 105 that can anatomically match and mate with substantially the remaining portion of thefemoral neck 86 in three dimensions, without requiring other supports to retain theguide 100 on the proximal femur. -
FIGS. 3-5 illustrate various exemplary patient-specific, unitary or single-component alignment guides 100 for the patient's proximal femur. Same reference numbers are used to refer to similar parts or features throughout various embodiments. New or additional elements are identified with new reference numbers. - Referring to
FIGS. 3 and 3A , a patient-specific alignment guide 100 according to the various embodiments can be constructed as a one-piece integral or monolithic component that has a three-dimensional inner patient-specific engagement surface 113 conforming to the corresponding anatomy of a specific patient, including subchondral bone with or without soft tissue. Thealignment guide 100 can include first andsecond arms 130 that are patient-specific, curved and substantially concave toward thefemoral neck 86 and extend anteriorly and posteriorly around thefemoral neck 86 without, however, fully encircling thefemoral neck 86. Thealignment guide 100 can be generally saddle-shaped and can include afirst portion 131 conforming to a portion of thefemoral head 84. Thefirst portion 131 can be patient-specific, curved and substantially concave toward thefemoral head 84. A guidingportion 108 with aninternal passage 109 can extend from thefirst portion 131 for guiding a pin, a drill bit or other tool. Thealignment guide 100 can also include asecond portion 132 extending from thefirst portion 131 along thefemoral neck 86 and abutting thegreater trochanter 76. Thesecond portion 132 can be patient-specific, conforming to the anatomy of thefemoral neck 86, such that thesecond portion 132 can be, for example, convex where the anatomy of the femoral neck. 86 is concave. Thefirst portion 131, thesecond portion 132 and the first andsecond arms 130 form the saddle shape of thealignment guide 100, as shown inFIG. 3 . Theengagement surface 113 includes the inner surfaces of thefirst portion 131, thesecond portion 132 and the first andsecond arms 130. The first andsecond arms 130 can be oriented substantially perpendicularly to the first andsecond portions alignment guide 100 can be positioned superiorly relative to the femur, as shown inFIG. 3 . - Referring to
FIGS. 4 and 4A , analignment guide 100 according to the various embodiments can include asecond portion 132 that can abut thelesser trochanter 78 of the patient's femur. In the embodiment illustrated inFIG. 4 , thealignment guide 100 can be positioned anteriorly or posteriorly relative to the femur and the first andsecond arms 130 can extend superiorly and inferiorly relative to the femur. Thealignment guide 100 shown inFIG. 4 can be substantially saddle-shaped and patient-specific in three dimensions. Thefirst portion 131 is patient-specific, curved and substantially concave inward and toward thefemoral head 84. Thesecond portion 132 is patient-specific, curved and substantially convex inward and toward the neck, and the first andsecond arms 130 are patient-specific, curved and substantially concave inward and toward thefemoral neck 86. Theengagement surface 113 includes the inner surfaces of thefirst portion 131, thesecond portion 132 and the first andsecond arms 130. The first andsecond arms 130 can be oriented substantially perpendicularly to the first andsecond portions - Referring to
FIGS. 5 and 5A , analignment guide 100 according to various embodiments can be positioned inferiorly relative to the femur and the first andsecond arms 130 can extend around thefemoral neck 86 posteriorly and anteriorly relative to the femur. Thealignment guide 100 shown inFIG. 5 is also saddle-shaped and patient-specific in three dimensions, with thefirst portion 131 being patient-specific, curved and substantially concave inward and toward thefemoral head 84, thesecond portion 132 being patient-specific, curved and substantially convex inward and toward the neck, and the first andsecond arms 130 being curved and concave inward and toward thefemoral neck 86. Theengagement surface 113 includes the inner surfaces of thefirst portion 131, thesecond portion 132 and the first andsecond arms 130. The first andsecond arms 130 can be oriented substantially perpendicularly to the first andsecond portions - The alignment guides 100 shown in
FIGS. 3A-5A can be made of biocompatible polymer or other material such that the first andsecond arms 130 that can flex to allow thealignment guide 100 to be snap on and held around thefemoral neck 86 without any other temporary fixation. Thealignment guide 100 can be also supported on the femur with removable fixators, such as pins. - In various embodiments, and referring to
FIGS. 6 , 6A and 6B, thealignment guide 100 can be in the form of a complete or partial shell encompassing thefemoral head 84 and having a patient-specific three-dimensionalinner engagement surface 113. Thealignment guide 100 can include first andsecond members portions connection 141. In various embodiments, the first andsecond members alignment guide 100 can be mounted by opening up the connectingportions more connections 141. In various embodiments, the first andsecond members connection 141. The first andsecond members FIG. 6 , with theinner surface 113 closely conforming to the substantially convex surface of thehead 84 and to the substantially concave surface of theneck 86. The first and second connectingportions FIGS. 6A and 6B . - It will be appreciated that other single or multiple-component guides can be similarly constructed for guiding and preparing other bone joints for receiving prosthetic components. Patient-specific guides can be, for example, constructed for the knee, the hip, the shoulder, etc, and can include two or more relatively movable and interconnected components. When more than two components are used, the same or different coupling mechanisms can be provided along the interfaces of the adjacent components. Each of the components can match a corresponding anatomic portion in three dimensions and can be configured for surgical placement on the patient and can include a guiding formation that is related to an axis associated with the anatomic portion. Such axes can be tangential or perpendicular or at other specified angle relative to the anatomic portion and relative to various anatomic axes of the joint, such as, for example, the mechanical axis, the epicondylar axis or other anatomic axis.
- Referring to
FIGS. 7-9 , a patient-specific alignment guide 200 according to various embodiments is illustrated. Thealignment guide 200 can include aframe 211 including a nut or other securingmember 202, abody 213, aremovable target member 212, and first andsecond arms body 213 with pins orother pivots 207. The securingmember 202 can be threadably connected to a threaded portion of apost 219 extending from thebody 213. First and second tabs orextensions second arms post 219. When the securingmember 202 is fully threaded to thepost 219, the securingmember 202 pushes against the first andsecond extensions second arms FIG. 7 . Thepost 219 can include a plurality of longitudinal passages 201 (shown inFIG. 8A ) having different orientations relative to and converging toward a longitudinal axis A of thepost 219, as shown inFIGS. 7 , 8A and 9. Thepassages 201 can be arranged to form a tool guide and can be used for passing guide wires, fixation pins, drills or other tools. The first andsecond arms specific clamping portions - The frame 211 (excluding the patient-specific portions discussed below) can be any instrument guiding frame for femoral resurfacing procedures, such as, for example, the RECAP® KS Alignment Device, commercially available from Biomet, Inc. of Warsaw, Ind. Further details of a related frame can be found in WIPO publication WO 2008/040961, the disclosure of which is incorporated herein by reference. Other embodiments of a
frame 211 according to the present teachings are discussed below. - Referring to
FIGS. 7A and 7B , in various embodiments according to the present teachings, each clampingportion femoral neck 86 or afemoral head 84 of a specific patient, as shown inFIGS. 7A and 8E , for example. The clampingportions arms FIG. 7 , thesecond arm 204 can include a pair of spaced-apart clampingportions 222 that are coupled to one another. It should be noted that one or both of the first andsecond arms - Referring to
FIGS. 7B and 7C , in various embodiments according to the present teachings, the first andsecond arms specific clamping portions second arms FIG. 7B , which shows an exemplary groove/slot 230 andtab 231 inarm 206 and a corresponding tab/extension/hook 233 and groove/slot 232 associated with clampingportion 220. Thetab 231 can be received inslot 232 while thetab 233 can be received inslot 230. It will be appreciated that the relative locations of the groove and tab can be reversed. Different types of removable connections can be used, including snap-on, dovetail, or other quick-coupling and de-coupling connections. Themodular clamping portions frame 211 can be sterilizable and reusable. In various embodiments, themodular clamping portions modular clamping portions frame 211, such as metallic materials for theframe 211 and plastic materials for themodular clamping portions - Referring to
FIG. 7D the clampingportions specific cover 240 can include a three-dimensional patientspecific surface 242. The patient-specific surface can be constructed from three-dimensional image data of the patient, as described above, and can closely match or conform, for example as negative mold, to a corresponding surface of the specific patient's femoral anatomy, such as thefemoral neck 86, as shown inFIG. 7A or thefemoral head 84, as shown inFIG. 8E . The patientspecific cover 240 can include a groove or slot or opening 244 for fitting thecover 240 onto thecorresponding clamping portion covers 240 can be made of a compliant, soft and flexible material, such as a plastic, for easy fitting onto the clampingportions reusable frame 211, such as a metallic frame. Thecovers 240 can also be provided in different sizes for non patient-specific uses. - Referring to
FIGS. 8-8D , the patient-specific alignment guide 200 can be provided with more than two arms, such as first, second andthird arms portions 220. The first, second andthird arms body 113. The clampingportions 220 can be patient specific for direct and full contact with the three-dimensional anatomy of thefemoral neck 86, as shown inFIGS. 8B and 8C , or the three-dimensional anatomy of thefemoral head 84, as shown inFIG. 8E , correspondingly providing curved surface contact with the femoral neck or femoral head. The clampingportions 220 can be modular, snap-on patient-specific components, such as those illustrated inFIG. 7B , or can be provided patient-specificdisposable covers 240, such as those illustrated inFIG. 7D . In various embodiments, the clampingportions 220 can include pointedtips 221 for point-contact at relative distances determined for a specific patient, as shown inFIG. 8C . Instead ofpoint tips 221, line edges can be used for patient-specific line contact in three dimensions. - In various embodiments, and referring to
FIG. 9 , the various clampingportions frame 211 in which the first andsecond arms femoral neck 86 orfemoral head 84. The first andsecond arms second extensions FIG. 9 . - The foregoing discussion discloses and describes merely exemplary arrangements of the present teachings. Furthermore, the mixing and matching of features, elements and/or functions between various embodiments is expressly contemplated herein, so that one of ordinary skill in the art would appreciate from this disclosure that features, elements and/or functions of one embodiment may be incorporated into another embodiment as appropriate, unless described otherwise above. Moreover, many modifications may be made to adapt a particular situation or material to the present teachings without departing from the essential scope thereof. One skilled in the art will readily recognize from such discussion, and from the accompanying drawings, that various changes, modifications and variations can be made therein without departing from the spirit and scope of the present teachings.
Claims (21)
Priority Applications (36)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/486,992 US8858561B2 (en) | 2006-06-09 | 2009-06-18 | Patient-specific alignment guide |
US12/571,969 US9173661B2 (en) | 2006-02-27 | 2009-10-01 | Patient specific alignment guide with cutting surface and laser indicator |
PCT/US2010/038845 WO2010148103A1 (en) | 2009-06-18 | 2010-06-16 | Patient specific alignment guide |
US12/893,306 US9113971B2 (en) | 2006-02-27 | 2010-09-29 | Femoral acetabular impingement guide |
US12/938,913 US9289253B2 (en) | 2006-02-27 | 2010-11-03 | Patient-specific shoulder guide |
US12/938,905 US20110046735A1 (en) | 2006-02-27 | 2010-11-03 | Patient-Specific Implants |
US12/955,361 US8591516B2 (en) | 2006-02-27 | 2010-11-29 | Patient-specific orthopedic instruments |
US12/973,214 US9345548B2 (en) | 2006-02-27 | 2010-12-20 | Patient-specific pre-operative planning |
US12/978,069 US8568487B2 (en) | 2006-02-27 | 2010-12-23 | Patient-specific hip joint devices |
US13/041,495 US8864769B2 (en) | 2006-02-27 | 2011-03-07 | Alignment guides with patient-specific anchoring elements |
US13/041,469 US8608749B2 (en) | 2006-02-27 | 2011-03-07 | Patient-specific acetabular guides and associated instruments |
US13/041,883 US10278711B2 (en) | 2006-02-27 | 2011-03-07 | Patient-specific femoral guide |
US13/041,665 US8535387B2 (en) | 2006-02-27 | 2011-03-07 | Patient-specific tools and implants |
US13/045,169 US20110172672A1 (en) | 2006-02-27 | 2011-03-10 | Instrument with transparent portion for use with patient-specific alignment guide |
US13/047,924 US20110190899A1 (en) | 2006-02-27 | 2011-03-15 | Patient-specific augments |
US13/111,007 US8603180B2 (en) | 2006-02-27 | 2011-05-19 | Patient-specific acetabular alignment guides |
US13/400,652 US9339278B2 (en) | 2006-02-27 | 2012-02-21 | Patient-specific acetabular guides and associated instruments |
US13/527,981 US9918740B2 (en) | 2006-02-27 | 2012-06-20 | Backup surgical instrument system and method |
US14/064,970 US9662216B2 (en) | 2006-02-27 | 2013-10-28 | Patient-specific hip joint devices |
US14/086,447 US9522010B2 (en) | 2006-02-27 | 2013-11-21 | Patient-specific orthopedic instruments |
US14/100,134 US9480580B2 (en) | 2006-02-27 | 2013-12-09 | Patient-specific acetabular alignment guides |
US14/105,669 US9662127B2 (en) | 2006-02-27 | 2013-12-13 | Patient-specific acetabular guides and associated instruments |
US14/483,214 US20140378979A1 (en) | 2006-02-27 | 2014-09-11 | Alignment Guides With Patient-Specific Anchoring Elements |
US14/798,809 US10206695B2 (en) | 2006-02-27 | 2015-07-14 | Femoral acetabular impingement guide |
US14/812,583 US20150335438A1 (en) | 2006-02-27 | 2015-07-29 | Patient-specific augments |
US14/865,762 US10426492B2 (en) | 2006-02-27 | 2015-09-25 | Patient specific alignment guide with cutting surface and laser indicator |
US15/008,528 US10390845B2 (en) | 2006-02-27 | 2016-01-28 | Patient-specific shoulder guide |
US15/093,384 US20160213491A1 (en) | 2006-02-27 | 2016-04-07 | Patient-specific pre-operative planning |
US15/130,414 US10507029B2 (en) | 2006-02-27 | 2016-04-15 | Patient-specific acetabular guides and associated instruments |
US15/267,714 US9913734B2 (en) | 2006-02-27 | 2016-09-16 | Patient-specific acetabular alignment guides |
US15/352,721 US9700329B2 (en) | 2006-02-27 | 2016-11-16 | Patient-specific orthopedic instruments |
US15/495,432 US20170224496A1 (en) | 2006-02-27 | 2017-04-24 | Patient-specific hip joint devices |
US15/672,724 US10603179B2 (en) | 2006-02-27 | 2017-08-09 | Patient-specific augments |
US15/878,984 US20180153565A1 (en) | 2006-02-27 | 2018-01-24 | Alignment guides with patient-specific anchoring elements |
US15/887,740 US10743937B2 (en) | 2006-02-27 | 2018-02-02 | Backup surgical instrument system and method |
US16/600,081 US11534313B2 (en) | 2006-02-27 | 2019-10-11 | Patient-specific pre-operative planning |
Applications Claiming Priority (7)
Application Number | Priority Date | Filing Date | Title |
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US81269406P | 2006-06-09 | 2006-06-09 | |
US89234907P | 2007-03-01 | 2007-03-01 | |
US11/756,057 US8092465B2 (en) | 2006-06-09 | 2007-05-31 | Patient specific knee alignment guide and associated method |
US95363707P | 2007-08-02 | 2007-08-02 | |
US12/025,414 US8298237B2 (en) | 2006-06-09 | 2008-02-04 | Patient-specific alignment guide for multiple incisions |
US12/039,849 US8282646B2 (en) | 2006-02-27 | 2008-02-29 | Patient specific knee alignment guide and associated method |
US12/486,992 US8858561B2 (en) | 2006-06-09 | 2009-06-18 | Patient-specific alignment guide |
Related Parent Applications (5)
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US12/103,834 Continuation-In-Part US7967868B2 (en) | 2006-02-27 | 2008-04-16 | Patient-modified implant and associated method |
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US12/571,969 Continuation-In-Part US9173661B2 (en) | 2006-02-27 | 2009-10-01 | Patient specific alignment guide with cutting surface and laser indicator |
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